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What Is a Capsulectomy? Implant Removal

A capsulectomy is a surgical procedure aimed at addressing issues with the fibrous tissue, or capsule, that naturally forms around foreign objects in the body, such as breast implants. This capsule provides support and keeps the implant in place, but it can sometimes cause problems.

In cases of capsular contracture, the capsule becomes abnormally thick and tight, leading to pain and breast distortion. A capsulectomy involves the removal of this hardened tissue to alleviate discomfort and restore a more natural appearance. This procedure is also commonly performed during implant removal, particularly when complications like infection, rupture, or cancer arise. During the surgery, the scar tissue is excised, and the implant is often replaced with a new one.

Capsulectomy vs. Capsulotomy

While they sound similar, a capsulectomy and a capsulotomy are distinct procedures for treating capsular contracture. In a capsulotomy, the surgeon cuts and loosens the capsule rather than removing it, reducing the pressure on the implant.

Both procedures are effective, but a capsulectomy is widely regarded as the gold-standard treatment, as it completely removes the problematic tissue.

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Types of Capsulectomy

There are three main types of capsulectomy procedures:

Subtotal or Partial Capsulectomy
In this approach, only a portion of the capsule is removed during the surgery.
Total or Complete Capsulectomy
The entire capsule surrounding the implant is surgically removed, typically in sections.
En Bloc Capsulectomy
This method involves removing both the implant and the capsule together as one intact unit. It often includes the removal of a thin layer of surrounding breast tissue. En bloc capsulectomy is a higher-risk and more complex procedure, usually reserved for cases involving serious conditions like breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Alternative Options

When ongoing capsular contracture is a concern or if a person chooses not to replace their implants after implant removal, autologous tissue reconstruction may be recommended. This technique uses the patient’s own tissue, taken from areas such as the abdomen, back, buttocks, or thighs, to reconstruct the breast.

Since natural tissue does not trigger capsule formation, autologous breast reconstruction eliminates the risk of capsular contracture reoccurring, making it a durable and effective option for some patients.

Purpose

The main goal of a capsulectomy is to address capsular contracture, a condition believed to be an exaggerated immune response to a breast implant. This reaction causes inflammation, leading to collagen production that makes the surrounding tissue thick and fibrous. Over time, this can make the breasts uncomfortably firm and even painful.

Capsular contracture can develop shortly after surgery or years later, affecting one or both breasts. It is categorized into four stages, known as Baker Grades:

Grade 1: The breast feels soft and looks natural.
Grade 2: The breast is slightly firm but still has a natural appearance.
Grade 3: The breast becomes firm, feels hard to the touch, and appears misshapen.
Grade 4: The breast is hard, painful, and significantly distorted.

For advanced cases (Grades 3 and 4), a capsulotomy or capsulectomy, often combined with implant replacement, is typically recommended.

Other Uses
Beyond treating capsular contracture, capsulectomy is performed for various other reasons, including:

Ruptured Implants: When the outer shell of a silicone implant tears or leaks.
Infection: If the capsule becomes infected.
Implant Extrusion: When an implant begins to push through the skin.
Breast Implant Illness (BII): A condition linked to symptoms like fatigue, muscle pain, and general malaise following implant placement.
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): A rare form of cancer that develops in the scar tissue around the implant.

Preparing for Surgery
Before undergoing a capsulectomy, several pre-operative tests are required to ensure the procedure is safe:

Blood Tests: Includes a complete blood count (CBC) and tests for clotting disorders.
Pregnancy Test: To confirm you are not pregnant.
Imaging Tests: May include a chest X-ray, breast ultrasound, or MRI.
Mammogram: Recommended if you are over 40 or have a higher risk of breast cancer.
Electrocardiogram (ECG): To evaluate heart health.

These evaluations help ensure you’re medically cleared for both the surgery and anesthesia, minimizing risks and complications.

After the Surgery

After your procedure, you will gradually wake up from anesthesia in the recovery room. It’s normal to feel drowsy, nauseous, and sore at first.

The nursing staff will keep a close eye on your vital signs and provide medications to help manage your discomfort.

If you are being discharged the same day, it will likely be a few hours after the surgery. If you’re staying overnight, you will be transferred to a hospital room once the medical team determines you’re stable and ready.

Recovery

The recovery time after a capsulectomy can vary based on the type of procedure performed, how extensive the surgery was, and whether implants are replaced. In general, recovery can take anywhere from four to six weeks.

During this period, you can expect some breast pain, swelling, and bruising. Numbness or sensations like tingling and burning in the breast area are also common and should resolve over time.

To help with discomfort, follow your surgeon’s instructions for pain relief. Gentle breast massage may also be recommended to reduce nerve sensitivity.

You may need to sleep on your back for a period of time to minimize swelling and help the healing process. It’s also important to wear your support bra as advised by your surgeon.

Showering

Most patients can shower 24 to 72 hours after surgery, but it’s important to follow your surgeon’s specific guidance. Check with your doctor to see if you can temporarily remove your bra while showering. If so, gently clean the incision sites and pat them dry with a clean towel. If adhesive strips are applied to your incisions, keep them in place as instructed. Avoid soaking in a tub until your stitches or drains have been removed, and your surgeon gives you clearance to do so.

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At LINIA, we promise to treat you as a valued individual with the utmost dignity and privacy.
At LINIA, we promise to ensure that your treatment is tailored to your personal needs.
At LINIA, we promise to provide post-operative care for life. T&C’s apply.
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What Our Patients Say

For over 25 years, patients have trusted us for expert treatments. Here’s what they have to say.

Just a quick note to say Thank you for my new boobs!!
I have always felt out of proportion, but now i feel whole for The first time in my life!
Thank you to you all for your care d expertise, and I hope to see you all again when I come down with Kristi next year.
Love Emma Baker (the twins!!)

Mr Aslam, Vicky + Addy
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Mr Aslam,
You kindly said you would be able to send me my “before + after” photo’s if I wrote to you, I would be grateful if I could have them to continue to admire your great work!!!
Many thanks,

Kay
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Dear Mr Aslam, Thank you so much for everything you have done. I’m so happy with the results!
Best wishes,

Paula Taylor
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Excellent service. Kind, friendly, reassuring and very professional from walking through the door to leaving resulting in outstanding results! Thank you

Janet & Michelle
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I honestly couldn’t recommend Linia enough, from start to finish they were absolutely amazing and my PC Lauren was such a star throughout. They turned what was a stressful situation for me from being let down by another company into such an exciting experience and my results are what I always dreamt of x

Ranjana
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I just want to say a big thankyou to the whole team!! I am absolutely amazed with the result. It was exactly how I wanted my breast to be. Thankyou Dr. Irshad from the consultation to the actual surgery. Thankyou Mojdeh you have been amazing!! Made me feel comfortable throughout the journey and reassured me with everything. THANKYOU ALL❤️

Z.C
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The process was amazing from start to finish. Dr Irshad did an amazing augmentation and I’m extremely happy with my results. His team were great. My Patient Support Advisor Jayne was always on hand if I had any issues or questions. I felt in safe hand with the surgical team. The hospital was lovely, clean and staff were friendly. I would 100% use them again in the future!

C.R
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The experience was absolutely amazing. I was in and out within 4 hours. The employees were very friendly and helpful. Mr Aslam was wonderful. He talked me through every step of the process. I was very well looked after and would highly recommend him to anyone. Many thanks to everyone at Harley St. Sobia you have been great. Thank you!

X
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I had a ba 3 weeks ago and I cannot THANK everyone enough. Everyone I met were amazing with me and so kind. I got quite emotional when I woke up after surgery and the ladies looking after me cared for me so much and I can’t be happier. Definitely recommend x

Millie Gould
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I had treatment with Dr Aslam, he and his staff are lovely, attentive and caring. Dr Aslam did an exceptional job with my treatment. Something that was my biggest insecurity I feel is now one of my assets! Highly recommend! Thank you so much for everything you have done.

Fabiane
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Had treatment by Dr. Irshad at Harley Street. Cant thank him or his team enough, the results are amazing!! Highly recommend Linia and Dr. Irshad for anyone looking into cosmetic surgery. The first consultation, the operation and post-op meetings have been great! 10/10

Lauren Oastler
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I can’t thank Linea enough for the amazing experience they provided me with, from consultations all the way through to post op appointments. Dr Aslam and his team were fantastic , I would highly reccomend them!

Jetta Falcone
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I’ve no complaints at all his surgery and staff are great and he’s in Harley Street(London) for a reason thanks Dr Aslam your clearly a very skilled professional

Jonny Bell
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Very good experience, excellent environment and good treatment. Recommended

Jacina Coyne
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Hello Everyone – I recently attended Linia Cosmetic Clinic at Harley Street. Yes! I was scared, nervous and excited at the prospect of an “S” lift, eye procedure and B.A whilst being aware and awake. SOUNDS silly but l enjoyed it, listening to everything being explained and some lovely music of my choice. Most important of all were the staff and Mr Aslam who made you feel relaxed and confident. So anyone considering? GO FOR IT.

Jack
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Neck Lift Procedure – Quick and Efficient. Good Quality Care and Follow Up. Very Good Results. Pleasant and Professional Staff. Experience was as Described.

jain smith
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Upper Eye Lid Surgery – I would highly recommend Linia they were very efficient from consultation through to the aftercare. I am very pleased with the surgery Dr Aslam carried out. I had the same surgery 10 years ago with Spire with minimal success. Thank you Linia.

christine
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Customer Service was excellent, staff were very supportive both prior to and following the procedure, answering any questions, worries or concerns that I had very quickly and thoroughly. Would recommend Linia and would definitely consider other procedures to be performed at Linia

Faizal
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Dr Aslam has been great during this experience. The Linia team and nurse staff have also done all they could to support me. I found having my op under local strange at first (I have a fear of needles). I was very worried – but having it done was great compared to general. My recovery time was much less and I was back to work much sooner than expected.

john
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Local anaesthetic was a much better experience than general. It was more relaxed and less painful. Recovery time was a lot quicker – there was no drowsiness or feeling sick. I would definitely use this option again if needed.

kate
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